tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS

Date:   24 December, 2009  
Focus: Small animals - dogs, cats, hamsters, guinea pig & rabbits.

Toa Payoh Vets Clinical Research
Making veterinary surgery alive
to a veterinary student studying in Australia
using real case studies and pictures

Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
First written: July 29, 2008
Update: Dec 24, 2009

In March 8, 2008, a very thin 4-year-old female Lhasa Apso that had a bit of sticky vaginal discharge for more than a week was sent to an emergency veterinary practice after midnight. She was diagnosed as pyometra but the owners did not want immediate surgery and consulted me.

This "emaciated" dog survived the general anaesthesia and surgery much to my surprise and the relief and delight of the teenaged girl. The close family of two parents, the teenaged daughter and son whom I had seen as children in the neighbourhood, spent many hours at the Surgery nursing and hand-feeding this "anorexic nervosa" pet.
Sometime in middle of 2009, I saw the dog who came in for her annual vaccination. I was surprised as she had gained weight and looked much healthier. Below are pictures of the Lhasa Apso in 2008 and her pyometra situation which, fortunately, had a happy outcome after surgery.
Open pyometra, emaciated, anaemic, dehydrated Lhasa Apso. Toa Payoh Vets Pyometra Lhasa Apso 4 years, Toa Payoh Vets
tpvets_logo.jpg (2726 bytes)1173.  Mar 8. 2008. Saturday.  A female 6-year-old Lhasa Apso could not open eyes at 10 pm at all. For the past 2 days, sticky pus from vagina. Rushed to a vet opening past midnight. Vet 1 diagnosed pyometra.  Advised a blood test and immediate surgery. Owner declined the blood test and waited till the next day to consult me. tpvets_logo.jpg (2726 bytes)1174. Mar 9, 2008. Sunday. Skin was not supple before rehydration with fluids. Tongue cyanotic. Immediate surgery would be high risk as the dog will die. But the womb may perforate and release pus killing the dog.
If the dog dies on the operating table, it is hard for the family and detrimental to the reputation of the operating vet. Few owners ever forgive or forget the vet when their dog dies on the operating table. Bad-mouthing from unsophisticated dog owners in Singapore is common. After all, the vet's performance outcome is a  death of the dog. 
Pyometra Lhasa Apso 4 years, Toa Payoh Vets
tpvets_logo.jpg (2726 bytes)1175. Mar 10, 2008. Monday. Dog rehydrated during past 24 hours. Sausage lump palpated. Mild lower abdominal pain. Owner did not want X-rays/blood test as vet costs add up here and there. All family members informed and met at 1 p.m. prior to surgery to see the dog. Just in case the dog dies on the operating table. tpvets_logo.jpg (2726 bytes)1176. Mar 10, 2008. Monday. Surgery. Wakes up fast when only gas anaesthesia is used. Use least % maintenance gas (to effect). Very fast surgery to minimise risk of death on the operating table.
Pyometra Lhasa Apso 4 years, Toa Payoh Vets Pyometra Lhasa Apso 4 years, Toa Payoh Vets
tpvets_logo.jpg (2726 bytes)1177. Mar 10, 2008. Dog seemed to have a good chance of survival. However, she will not eat by herself. Now not dehydrated. tpvets_logo.jpg (2726 bytes)1178. Mar 11, 2008. Tuesday. 5 pm. Went home. Active. Advised hand feeding of nutritious food in small amounts every 2 hour & good care. No scavenging. Family members are very happy and grateful. 
Not all pyometra cases have happy outcomes as Vets Are Not Gods.  Some seriously ill pyometra dogs still die from kidney failure a few days after a successful surgery. Therefore check your female dog daily and get her treated by your vet or spayed if she had dirty vaginal discharge. You may not want to spay her as advocated by so many animal welfare groups and vets. If that is your position, you have a responsibility to ensure that she has normal heat periods and health.    
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 Clinical Research

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